MEDICARE: HANDS OF PEACE ASSISTED LIVING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1760058234
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANDS OF PEACE ASSISTED LIVING LLC

Provider Business Mailing Address
First Line	:	1705 NORCOL LN
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45231-5225
Country	:	US
Telephone Number	:	513-604-5546
Fax Number	:

Provider Business Practice Location Address
First Line	:	1705 NORCOL LN
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45231-5225
Country	:	US
Telephone Number	:	513-604-5546
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PRINCIE DUNN
Credential	:
Telephone Number	:	513-604-5546

Provider Enumeration Date	:	06/03/2021
Last Update Date	:	06/06/2021

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